Classification of blood pressure during sleep impacts designation of nocturnal nondipping

• DOI: 10.1371/journal.pdig.0000267
• Publication Date: 2023-06-13T17:23:26Z
• Authors: Bobak J. Mortazavi; Josefa L. Martine...; Baylah Tessier-Sh...; Matthew Burg; Mary Miller; Zhale Nowroozilarki; O. Peter Adams; Rohan Maharaj; Cruz M. Nazario; Maxine Nunez; Marcella Nunez-Smith; Erica S. Spatz
• Keywords: Concordance; Sleep

The identification of nocturnal nondipping blood pressure (< 10% drop in mean systolic from awake to sleep periods), as captured by ambulatory monitoring, is a valuable element risk prediction for cardiovascular disease, independent daytime or clinic measurements. However, capturing measurements, including determination wake/sleep periods, challenging. Accordingly, we sought evaluate the impact different definitions and algorithms defining onset on classification nondipping. Using approaches based upon participant self-reports, applied definition common period (12 am -6 am), manual actigraphy, automated actigraphy identified changes nondipping, conducted secondary analysis potential an monitor sleep. Among 61 participants Eastern Caribbean Health Outcomes Research Network hypertension study with complete data, concordance across methods was 0.54 Fleiss’ Kappa (depending method, 36 51 classified having nondipping). Sleep quality dipping versus significantly total length when wearing (shorter duration) not (longer duration), although there were no differences efficiency disturbances. These findings indicate that consideration time measurements critical interpreting pressure. As technology advances detect patterns, further investigation needed determine which method should be used diagnosis, treatment, future risk.